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General NPI Number Information
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NPI Number | 1659119352
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Entity Type | Individual
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Provider Name | JOSHUA GAIGE MASON APRN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/17/2024
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 1615 W CHURCH ST STE 100
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City | LIVINGSTON
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State | TX
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Zip | 77351-8862
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Country | US
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Telephone | 888-634-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 636 E OAK LN
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City | NACOGDOCHES
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State | TX
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Zip | 75961-4707
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Country | US
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Telephone | 936-652-5059
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1168987
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License Number State | TX
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